胃癌根治术后胆囊结石形成的相关高危因素分析及对策  

The related high risk factors analysis and countermeasures of gallstones formation after radical gastrectomy for gastric cancer

作　　者：刘耿[1] 刘洪锋[1] LIU Geng;LIU Hongfeng(Department of General Surgery of Ward Three,The First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan 473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院普外三科,河南南阳473000

出　　处：《安徽医药》2020年第11期2238-2240,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨胃癌根治术后胆囊结石形成的相关高危因素及对策。方法选取2014年6月至2018年6月南阳医学高等专科学校第一附属医院收治的胃癌根治术术后病人162例,将复诊发现术后合并胆囊结石的22例病人作为观察组,其余140例作为对照组,对两组病人相关因素进行单因素非条件和多因素非条件的Logistic回归分析。结果单因素分析结果显示性别(χ^2=4.372,P=0.037)、十二指肠旷置(χ^2=6.831,P=0.009)、手术方式(χ^2=6.202,P=0.128)、淋巴结清扫数目(t=8.4312,P<0.001)、十二组淋巴结清扫(χ^2=4.047,P=0.044)、切除范围(χ^2=7.236,P=0.007)与胆囊结石形成具有相关性,差异有统计学意义(P<0.05);多因素非条件的Logistic回归分析显示手术方式(OR=3.49,P=0.001)、十二指肠旷置(OR=2.06,P=0.009)、淋巴结清扫数目(OR=1.50,P=0.025)、十二组淋巴结清扫(OR=1.84,P=0.018)、切除范围(OR=3.36,P=0.007)是胃癌根治术后胆囊结石形成的独立危险因素。结论胃癌根治术后胆囊结石形成可能是多种因素共同作用的结果,对相关危险因素积极进行干预,可最大限度降低胃癌根治术后胆囊结石的发生率。Objective To explore the related risk factors and countermeasures of gallstones formation after radical gastrectomy for gastric cancer.Methods 162 cases of patients with radical gastrectomy were analyzed in The First Affiliated Hospital of Nanyang Medical College from June 2014 to June 2018,There were 22 cases of patients with the formation of cholecystolithiasis(observation group),the rest of 140 patients was control group,two groups have single factor non-conditional and non-conditional logistic regression analysis.Results Single factor analysis results shows that Gender(χ^2=4.372,P=0.037),putting-aside of duodenum(χ^2=6.831,P=0.009),surgery way(χ^2=6.202,P=0.128),number of lymph node dissection(t=8.4312,P<0.001),12 groups of lymph node dissection(χ^2=4.047,P=0.044)and resection range(χ^2=7.236,P=0.007)were correlated with gallbladder stone formation are closely related with gallstone formation.the difference is statistically significant(P<0.05);Multiple factors of the unconditioned Logistic regression analysis shows that surgery way(OR=3.49,P=0.001),putting-aside of duodenum(OR=2.06,P=0.009),number of lymph node dissection(OR=1.50,P=0.025),12 groups of lymph node dissection(OR=1.84,P=0.018)and resection range(OR=3.36,P=0.007)were correlated with gallbladder stone formation are independent risk factors of gallstone formation.Conclusion positive intervention measures are put into effect for gallbladder stone formation after radical gastrectomy for gastric cancer.it has important clinical significance for the prevention and treatment of gallbladder stone formation after radical gastrectomy.

关 键 词：胆囊结石病 胃切除术 手术后并发症 胃癌根治术 高危因素 干预 

分 类 号：R735.2[医药卫生—肿瘤] R575.62[医药卫生—临床医学]